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Calendar Year 2021 Results

Behavioral Risk Factor Surveillance System (BRFSS)

2021 BRFSS Topics by Risks, Conditions, and Quality of Life

CDC - Core Sections
Health Status Healthy Days Health Care Access Exercise (Physical Activity) Hypertension Awareness Cholesterol Awareness Chronic Health Conditions	Arthritis Demographics (Disability) Tobacco Use Alcohol Consumption Immunization HIV/AIDS Fruits and Vegetables
CDC - Optional Modules
Pre-Diabetes Diabetes	Home/Self-Measured Blood Pressure Caregiver Firearm Safety
North Carolina Added Questions
Secondhand Smoke Other Tobacco Products Smoking Cessation Sugar-Sweetened Beverages Use of Trails and Greenways	Depression and Anxiety Housing Insecurity Food Insecurity Reactions to Race Derived Variables and Risk Factors

BRFSS 2021 Annual Results Technical Notes

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Health Status (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Would you say that in general your health is:
• General Health Indicator

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Healthy Days (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
• Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
• During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
• Frequent Mental Distress (within the past 30 days)

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Health Care Access (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare, or Indian Health Service?
• Health Insurance Coverage (Under Age 65)
• Health Insurance Coverage for Those Employed for Wages (Under Age 65)
• Do you have one person or a group of doctors that you think of as your personal health care provider?
• Was there a time in the past 12 months when you needed to see a doctor but could not because you could not afford it?
• A routine checkup is a general physical exam, not an exam for a specific injury, illness, or condition. About how long has it been since you last visited a doctor for a routine checkup??
• What is the current primary source of your health care coverage?
• Health care coverage status past 12 months

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Exercise (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?

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Hypertension Awareness (see results for 2011, 2013, 2015, 2017)

• Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?
• Are you currently taking prescription medicine for your high blood pressure?
• Adults who have been told they have high blood pressure by a doctor, nurse, or other health professional (CDC calculated variable)

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Cholesterol Awareness (see results for 2011, 2013, 2015, 2017, 2019)

• Blood cholesterol is a fatty substance found in the blood. About how long has it been since you last had your blood cholesterol checked?
• Have you ever been told by a doctor, nurse or other health professional that your blood cholesterol is high?
• Are you currently taking medicine prescribed by a doctor or other health professional for your blood cholesterol?
• Adults who have had their cholesterol checked and have been told by a doctor, nurse, or other health professional that it was high (CDC calculated variable)
• Cholesterol check within past five years (CDC calculated variable)

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Chronic Health Conditions (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

Has a doctor, nurse, or other health professional EVER told you that you had any of the following?

• (Ever told) you had a heart attack also called a myocardial infarction?
• (Ever told) you had angina or coronary heart disease?
• (Ever told) you had a stroke?
• History of Any Cardiovascular Diseases (heart attack or coronary heart disease or stroke)
• (Ever told) you had asthma?
• Do you still have asthma?
• (Ever told) you had skin cancer?
• (Ever told) you had any other types of cancer?
• (Ever told) you have (COPD) chronic obstructive pulmonary disease, emphysema or chronic bronchitis?
• (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
• (Ever told) you have a depressive disorder, including depression, major depression, dysthymia, or minor depression?
• Not including kidney stones, bladder infection or incontinence, were you ever told you had kidney disease?
• (Ever told) you have diabetes?
• How old were you when you were told you had diabetes?
• Summary Index of Chronic Health Conditions

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Arthritis (see results for 2011, 2013, 2015, 2017, 2019)

• Has a doctor, nurse or other health professional ever told you that you had some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
• Has a doctor or other health professional ever suggested physical activity or exercise to help your arthritis or joint symptoms?
• Have you ever taken an educational course or class to teach you how to manage problems related to your arthritis or joint symptoms?
• Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?
• In the next question, we are referring to work for pay. Do arthritis or joint symptoms now affect whether you work, the type of work you do or the amount of work you do?
• Please think about the past 30 days, keeping in mind all of your joint pain or aching and whether or not you have taken medication. During the past 30 days, how bad was your joint pain on average on a scale of 0 to 10 where 0 is no pain and 10 is pain or aching as bad as it can be?
• Limited usual activities (Arthritis) (CDC calculated variable)
• Limited work activities (Arthritis) (CDC calculated variable)

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Demographics (Disability Questions) (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Are you deaf or do you have serious difficulty hearing?
• Are you blind or do you have serious difficulty seeing, even when wearing glasses?
• Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?
• Do you have serious difficulty walking or climbing stairs?
• Do you have difficulty dressing or bathing?
• Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?
• Functional Disability Status

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Tobacco Use (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Have you smoked at least 100 cigarettes in your entire life?
• Do you now smoke cigarettes everyday, some days, or not at all?
• Do you currently use chewing tobacco or snuff every day, some days, or not at all?
• Have you ever used an e-cigarette or other electronic vaping product, even just one time, in your entire life?
• Do you now use e-cigarettes or other electronic vaping products every day, some days, or not at all?
• E-Cigarette/Vaping Status
• Smoking Status
• Current Smoker
• Use of Multiple Tobacco Products
• Use of Any Tobacco Product

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Alcohol Consumption (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?
• One drink is equivalent to a 12 ounce beer, a 5 ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?
• Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 or more drinks for men or 4 or more drinks for women] on an occasion?
• During the past 30 days, what is the largest number of drinks you had on any occasion?
• Binge Drinking
• Heavy Drinking
• Moderate Drinking Guidelines
• Excessive Drinking

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Immunization (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• During the past 12 months, have you had either a flu vaccine that was sprayed in your nose or a flu shot injected into your arm?
• At what kind of place did you get your last flu shot or vaccine?
• Have you ever had a pneumonia shot also known as a pneumococcal vaccine?

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H.I.V/AIDS (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019)

• Including fluid testing from your mouth, but not including tests you may have had for blood donation, have you ever been tested for H.I.V?
• Not including blood donations, in what month and year was your last H.I.V. test?

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Fruits and Vegetables (see results for 2011, 2013, 2015, 2017, 2019)

• Consumed fruits or vegetables or beans five or more times per day
• Consumed fruit one or more times per day. (CDC calculated variable)
• Consumed vegetables one or more times per day. (CDC calculated variable)

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Pre-Diabetes (see results for 2011, 2012, 2013, 2015, 2017, 2018, 2019)

• Have you had a test for high blood sugar or diabetes within the past three years?
• Have you ever been told by a doctor or other health professional that you have pre-diabetes or borderline diabetes?

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Diabetes (see results for 2011, 2012, 2013, 2015, 2017, 2019)

• Has a doctor, nurse, or other health professional EVER told you that you have diabetes?
• How old were you when you were told you have diabetes?
• Are you now taking insulin?
• About how often do you check your blood for glucose or sugar?
• Including times when checked by a family member or friend, about how often do you check your feet for any sores or irritations?
• About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?
• About how many times in the past 12 months has a doctor, nurse, or other health professional checked you for A-one-C?
• About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?
• When was the last time you had an eye exam in which the pupils were dilated, making you temporarily sensitive to bright light?
• Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?
• Have you ever taken a course or class in how to manage your diabetes yourself?

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Home Self-Measured Blood Pressure

• Has your doctor, nurse or other health professional recommended you check your blood pressure outside of the office or at home?
• Do you regularly check your blood pressure outside of your healthcare professional’s office or at home?

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Caregiver (see results for 2011, 2017)

• During the past 30 days, did you provide regular care or assistance to a friend or family member who has a health problem or disability?
• What is his or her relationship to you?
• How old is the person to whom you are giving care?
• For how long have you provided care for that person?
• In an average week, how many hours do you provide care or assistance?
• What is the main health problem, long-term illness, or disability that the person you care for has?
• In the past 30 days, did you provide care for this person by managing personal care such as giving medications, feeding, dressing, or bathing?
• In the past 30 days, did you provide care for this person by managing household tasks such as cleaning, managing money, or preparing meals?
• In the next 2 years, do you expect to provide care or assistance to a friend or family member who has a health problem or disability?

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Firearm Safety (see results for 2011, 2019)

• Gun Ownership
• Are any firearms kept in or around your home?
• Are any of these firearms now loaded?
• Are any of these loaded firearms also unlocked? By unlocked, we mean you do not need a key or a combination or a hand/fingerprint to get the gun or to fire it. We don't count a safety as a lock.

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Secondhand Smoke (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• On how many of the past 7 days, did someone smoke in your indoor workplace while you were there?
• On how many of the past 7 days, did anyone smoke in your home while you were there?
• On how many of the past 7 days, did you smell tobacco smoke from someone else's cigarette, cigar, or pipe drifting into your home from nearby apartments or from outside?

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Other Tobacco Products (see results for 2011, 2012, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• During the past 30 days, did you smoke cigars, cigarillos, or little cigars?
• During the past 30 days, have you used a hookah or water pipe?

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Smoking Cessation (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• In the past 12 months, did any doctor, dentist, nurse, or other health professional advise you to quit smoking cigarettes or using any other tobacco products?
• Did your doctor or health provider recommend medications and/or discuss methods and strategies other than medication (such as referrals to Quitline, counseling opportunities, or educational materials such as booklets or pamphlets) to assist you to quit smoking?
• During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?

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Sugar Sweetened Beverages (see results for 2012, 2013, 2015, 2017, 2019)

• During the past 30 days, how often did you drink regular soda or pop that contains sugar? Do not include diet soda or diet pop.
• During the past 30 days, how often did you drink sugar-sweetened fruit drinks (such as Kool-aid and lemonade) sweet tea, and sports or energy drinks (such as Gatorade and Red Bull)? Do not include 100% fruit juice, diet drinks, or artificially sweetened drinks.
• HNC2030 sugar-sweetened beverage indicator

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Use of Trails and Greenways (see results for 2012, 2013, 2015, 2017, 2019)

• Does your community have trails, greenways, bike paths, or sidewalks for biking, walking, or other activities?
• How often do you use these for biking, walking or other activities?

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Depression and Anxiety

• Screened Positive for Anxiety?
• Screened Positive for Depression?
• Psychological Distress Category

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Housing Insecurity

• During the past 12 months, was there a time when you were not able to pay your mortgage or rent?
• During the past 12 months, did you have to move because you were not able to pay your mortgage or rent?
• During the past 12 months, was there a time when you were not able to pay your utility bills?

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Food Insecurity

• For each statement, please tell me whether the statement was often true, sometimes true, or never true for your household in the last 12 months. "We worried whether our food would run out before we got money to buy more." In the last 12 months, was that…
• "The food that we bought just didn’t last, and we didn’t have money to get more." In the last 12 months, was that…

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Reactions to Race

• Within the past 12 months, when seeking health care, do you feel your experiences were worse than, the same as, or better than for people of other races?
• Within the past 12 months at work, do you feel you were treated worse than, the same as, or better than people of other races?
• Within the past 30 days, have you experienced any physical symptoms, for example, a headache, an upset stomach, tensing of your muscles, or a pounding heart, as a result of how you were treated based on your race?
• Within the past 30 days, have you felt emotionally upset, for example angry, sad, or frustrated, as a result of how you were treated based on your race?
• How do other people usually classify you in this country? Would you say: White, Black or African American, Hispanic or Latino, Asian, Native Hawaiian or Other Pacific Islander, American Indian or Alaska Native, or some other group?

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Derived Variables and Risk Factors (see results for 2011, 2012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020)

• Body Mass Index Grouping-Underweight, Recommended Range, Overweight and Obese
• Adults who have a body mass index greater than 25.00 (Overweight or Obese)
• Health Insurance Coverage - Age Under 65
• Health Insurance Coverage for Those Employed for Wages (Age Under 65)
• Smoking Status
• Current Smoker
• Binge Drinking
• Heavy Drinking
• Cholesterol check within past five years (CDC calculated variable)
• Excessive Drinking
• Adults who have been told they have high blood pressure by a doctor, nurse, or other health professional (CDC calculated variable)
• Adults who have had their cholesterol checked and have been told by a doctor, nurse, or other health professional that it was high (CDC calculated variable)

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